Police Officer

Online Application

• Name (First/Middle/Last) *
• Telephone Number *
• Street Address *
• Town/City *
• State *
• Zip Code *
• Mailing Address (if different than residence)
• Email Address *
• Date of Birth *
• Are you a citizen of the United States?
  * Yes No
• If you are not a citizen of the United States please provide your alien registration number
• Are you a high school graduate?
  * Yes No
• If you are not a high school graduate, do you possess a G.E.D. or equivalent? Yes No
• Do you possess a valid driver's license?
  * Yes No
• State Driver's license number
• Are you a defendant in a Final Order For Relief From Abuse?
  * Yes No
• Have you been convicted of any criminal offense? (if yes, please list below)
  * Yes No
• If you have been convicted of a criminal offense please explain the circumstances.
• Are you currently certified as a police officer?
  * Yes No
• If yes, in what state are you certified police officer?
• If you are a certified police officer, are you full or part time certified?
• If you are a certified police officer, are you subject to a Brady or Diglio letter?
• Have you ever been terminated from a law enforcement or corrections position?
  * Yes No
• If you have ever been terminated from a law enforcement or corrections position, please explain the circumstances.
• What special skills or personality traits do you have that might be considered an asset to this position?
• Other information
• By checking yes, I certify that the information contained in this application is true and correct. I understand that filing false or misleading information will subject me to disqualification for the position of police officer, or, if hired, may be the basis for termination.
• * Yes No
• Recaptcha requires verification. I'm not a robot reCAPTCHA This application is the initial screening for the entry-level position of Police Officer for the
• Town of Middlebury, to ensure that minimal qualifications for the position are met. At a later point in the selection process, a more detailed personal history statement will be required from all candidates successfully completing the initial testing and screening.
• Any misleading or false information submitted at any stage of the screening and selection process will result in disqualification from this position.

The Town of Middlebury is an equal opportunity employer.